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What Caused the SARS Epidemic?

What Caused the SARS Epidemic?

It’s been 17 years since the SARS (Severe Acute Respiratory Syndrome) epidemic captured the world’s attention. A coronavirus that originated from China caused the outbreak in November 2002. It shares a few key similarities to today’s coronavirus outbreak, COVID-19.

What caused the SARS epidemic in 2003? How did the virus spread globally and infect thousands in less than a year? Due to its similarity with COVID-19, many people believe that learnings from the SARS outbreak would help the world deal better with the modern-day pandemic.

According to the US Centers for Disease Control and Prevention, the first case of SARS was reported on November 16, 2002, at the Southern Chinese province of Guangdong. The virus, which the World Health Organization (WHO) identified as SARS-CoV, was believed to have originated from an unknown animal.

What caused the SARS epidemic?

Carriers had unknowingly spread the virus across China, eventually, infecting neighboring countries, Hong Kong and Vietnam.

The index case, or the first documented case, involved a 64-year-old Chinese physician and medical professor named Liu Jianlun.

Prior to his trip to Hong Kong in February 2003, he had contracted SARS after being exposed to the virus in a medical facility.

He reportedly traveled to Hong Kong five days after the onset of symptoms.

He succumbed to the illness within two weeks, but not before infecting guests at the Metropole Hotel in Hong Kong where he stayed.

what caused the sars epidemic

This highlights one of several risks that the medical community faced during the 2003 epidemic.

Initial carriers of the virus put health workers at risk. Health workers were susceptible to contracting and spreading the virus exponentially due to the nature of their work.

Some other factors contributed to the spread of the SARS epidemic:

  • Health officials believed that the initial onset was due to atypical pneumonia, a type of pneumonia that was caused by another bacterium. This led to misidentifying the contagion risk of the patient.
  • There were cases of super-spreaders, such as Liu Jianlun, who infected other guests. They, in turn, spread the disease to more people upon returning to their home countries of Vietnam, Canada, and Singapore.
  • Liu was also believed to have infected several healthcare workers at Kwong Wah Hospital in Hong Kong. It was there where he had been admitted and later succumbed to SARS.
  • The WHO also stated the possibility that the centers that had handled the deadly 2003 virus could be at fault. As they lacked proper infectious disease control precautions, this led to hospital staff contracting and spreading the virus further.
  • Consumption of infected exotic animal reservoirs, e.g. Chinese palm civets and horseshoe bats. Viruses isolated from these animals closely resemble the human SARS coronavirus. And they share similar mechanisms for gaining entry into the body. This led to the policies on controlling possible animal intermediaries as preventive measures for re-emergence of SARS.

What we learned from SARS

what caused the sars epidemic

It took a few months after the initial outbreak in Guangdong before China was able to share more information about the disease to the WHO. In March 2003, the WHO finally issued a global alert notifying the medical community regarding a severe form of pneumonia with unknown origins. And it issued several travel advisories in April 2003.

This highlights the importance of transparency during times of epidemics. Chinese officials reported the first known case of COVID-19 on December 31, 2019, amidst growing concern of underreported cases prior to the date.

It was July 2003 when the WHO declared the end of the SARS epidemic. To date, there are still no known vaccines for the virus. Fortunately, healthcare workers have contained the virus mostly in laboratory environments, with a limited number of cases.

What can we apply today based on the 2003 SARS epidemic?

The 2003 SARS epidemic resulted in more than 8,000 confirmed cases across 29 territories, with China, Hong Kong, and Taiwan reporting the highest number of infections. Outside of Asia, Canada reported the most cases of infections due to a traveller who contracted the disease at the Metropole Hotel.

COVID-19 has already surpassed these figures. Globally, as of 17 September 2020, there have been 29,737,453 confirmed cases of COVID-19. This includes 937,391 deaths, according to the WHO.

This presents a more pressing need to properly handle and contain the epidemic. And this needs to be done on both the national government and individual level.

Due to the similarity of the two viruses, we can apply learnings from what caused the SARS epidemic to today’s COVID-19 epidemic.

SARS and COVID-19: What we’ve learned

  • SARS presented mostly the same symptoms as COVID-19. Its mode of transmission is similar. Coughing or sneezing transmits the SARS virus. From this, we can continue to observe proper social distancing, and avoiding large crowds. Practicing good hygiene is also crucial.
  • Media covered the early months of the 2003 SARS epidemic extensively. But when they were unable to share more info about its origins, and because of the fact that there was still no cure at the time, there was only panic and anxiety among the public. With the current COVID-19 situation, it’s important for governments and individuals to be transparent, and to share only accurate information about the outbreak.
  • Majority of the transmissions from the 2003 SARS epidemic occurred within the healthcare setting. Today, we see a similar trend in the Philippines, with at least 21 doctors losing their lives while caring for COVID-19 patients as of April 2020.

These deaths mean a great loss. Healthcare workers on the frontline are at a significant risk.

The proper use and distribution of personal protective equipment (PPE) for healthcare workers is a must. Honest and transparent sharing of information can also greatly help in protecting both the public and the healthcare workers.

Medical technology has grown leaps and bounds since the SARS epidemic. But COVID-19 has shown us that we remain ill-prepared as a global community to deal with the current outbreak.

While we must continue to trust our governments and medical institutions in dealing with these outbreaks safely and efficiently, we must also practice sound judgment to avoid contributing to the spread of the epidemic.


Learn more about Infectious Diseases, here.

Hello Health Group does not provide medical advice, diagnosis or treatment.

CDC SARS Response Timeline, https://www.cdc.gov/about/history/sars/timeline.htm, Accessed 18 September 2020 SARS Pandemic: How the Virus Spread Around the World in 2003, https://www.history.com/news/sars-outbreak-china-lessons, Accessed 18 September 2020 Rolling updates on coronavirus disease (COVID-19), https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen, Accessed 18 September 2020 CDC COVID Data Tracker, https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html, Accessed 18 September 2020 SARS (Severe Acute Respiratory Syndrome), https://www.who.int/ith/diseases/sars/en/, Accessed 18 September 2020 Atypical pneumonia, https://medlineplus.gov/ency/article/000079.htm, Accessed 18 September 2020 Coronavirus disease (COVID-19) pandemic, https://www.who.int/emergencies/diseases/novel-coronavirus-2019, Accessed 18 September 2020 WHO Coronavirus Disease Dashboard, https://covid19.who.int/, Accessed 18 September 2020  
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Written by JB Aquino Updated Sep 18, 2020
Medically reviewed by Mike-Kenneth Go Doratan, M.D.